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It may seem like it's much easier to just continue effortlessly with an existing health insurance plan versus going through the extra work of evaluating new options and possibly even changing plans, but the fact is, with help from an experienced health insurance agent, finding and applying for a new health plan can be simple.
The key is knowing when and why it would make sense to switch to a new plan, and when it would not. A qualified health insurance consultant can assist you in evaluating the data to make the best decision for you.
Here are 4 reasons why it might be a good idea to switch to a new health insurance carrier or to adjust your plan with your current insurer:
1. Your Old Plan Is Now Non-existent
Market forces are continually moving and insurers sometimes do find the need to change their plan designs and product portfolio each year. Some insurers have left the Federally Facilitated Marketplace entirely, which could mean that you won’t qualify for a subsidy if you are enrolled for one of their plans, even if you were subsidized in previous years.
Or, the same insurer might still be there, but the terms of your existing policy could have changed drastically. Maybe your premiums have gone up a lot, the deductible has been raised higher, or the copays have been restructured for things like doctors visits, diagnostic, and pharmacy benefits. You don't want to stay in a plan that no longer meets your needs and you certainly don’t want to be blindsided by changes that you didn’t understand or were not aware of.
2. Your Income/Expenses Have Gone Up Or Down
To a large extent, in the Federally Facilitated Marketplace, the cost of health insurance plans can be different for people at different income levels. First of all, you have to be able to afford the premiums. But also, lower incomes may qualify for greater subsidies than higher incomes would allow, which might allow you to purchase a richer plan with better benefits and less out of pocket exposure to you.
It's the income vs expense ratios that need to be reconsidered each and every year. Whether you are receiving a premium subsidy or maintain a higher than average income; if you are enrolled in a very rich plan now (like a Gold or Platinum level) you may need to review the value of the benefits, vs cost, vs your actual healthcare needs to make sure you aren’t over-insuring yourself. This has to be assessed on an individual, case by case basis.
3. Your Family Size or Health Needs Have Changed
You may especially need to talk to a health insurance advisor if your family size has changed over the previous year. A new person added to your overall health care strategy for your family means big changes - and could also mean a new health plan.
Likewise, if the health and wellness level of one or more family members has changed, you might also be wise to reevaluate your current health plan’s benefits. A greater health need might warrant you moving to a plan with a lower deductible or stronger copays. But also, should someone’s health circumstance improve, you might be able to reduce your overall expenses for the year ahead by choosing a lower cost plan.
4. You Qualify For A Special Enrollment Period
If you missed the Federal Marketplace’s open enrollment period for 2019, which was November-December 2018, then at this point in time you’ll probably need an adviser to help direct you to alternative coverage options. You may have to get a short term medical plan to cover you through the end of the year unless you are eligible for special enrollment due to a qualifying life event.
Those who give birth to a child, adopt a child, change jobs, go through a divorce or the death of a spouse, or experience a loss in prior coverage outside of their control, could qualify for mid-year special enrollment. The ACA only allows a 60-day window of opportunity from the date of the said event, so these individuals would want to contact a health insurance advisor immediately.
For assistance in choosing your new plan, or advice on whether or not to switch carriers or coverage, contact Summerlin Benefits Consulting today!